Comparison of Pediatric and Adult Firearm Deaths to Inform Violence Prevention at Pediatric Trauma Centers.

Introduction: Hospital-based violence intervention programs primarily target adults, raising questions about the effectiveness in preventing pediatric firearm deaths. We hypothesized that pediatric and adult firearm injury deaths are different enough to require unique intervention strategies.

Methods: Retrospective chart review was conducted of medical examiner and trauma center records of firearm-related deaths in the largest metropolitan county in Texas.

Inflammatory Markers and Measures of Cardiovascular Autonomic Neuropathy in Type 1 Diabetes.

Background: Cardiovascular autonomic neuropathy (CAN) and inflammation predict more severe outcomes in type 1 diabetes (T1D). However, the link between CAN and inflammation in T1D remains unclear. We examined associations between CAN measures and inflammatory biomarkers in individuals with T1D.

Defining Renal Recovery in Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies.

Introduction: The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.

Methods: A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of > 30% improvement in SCr and its association with clinical outcomes.

Possible Factor Xa Resistance in a Patient Who Failed Apixaban and Rivaroxaban.

This article aims to discuss the literature on switching to an anticoagulant with a different mechanism of action in case of treatment failure. We present a patient with atrial fibrillation who incurred an embolic stroke despite adequate anticoagulation with apixaban and developed a new symptomatic ischemic stroke during the same admission after switching to rivaroxaban, a factor Xa inhibitor with a similar mechanism of action. He had no new events at 3-months after switching to dabigatran, a direct thrombin inhibitor.

Embolic Materials' Comparison in Meningeal Artery Embolization for Chronic Subdural Hematomas: Multicenter Propensity Score-Matched Analysis of 1070 Cases.

Background And Objectives: Multiple preferences exist for embolic materials selection in middle meningeal artery embolization (MMAE) for chronic subdural hematoma with limited comparative literature data. Herein, we compare different embolic materials.

Methods: Consecutive patients undergoing MMAE for chronic subdural hematoma at 14 North-American centers (2018-2023) were classified into 3 groups: (a) particles, (b) Onyx, (c) n-butyl cyanoacrylate (n-BCA).

Immediate Versus Staged Complete Revascularization for Patients With ST-Segment-Elevation Myocardial Infarction and Multivessel Disease: A Network Meta-Analysis of Randomized Trials.

Background: The comparative outcomes with immediate, staged in-hospital, and staged out-of-hospital complete revascularization for patients with ST-segment-elevation myocardial infarction and multivessel disease remain unclear.

Methods And Results: An electronic search of MEDLINE, SCOPUS, and Cochrane databases was performed through August 2023 for randomized trials evaluating immediate, staged in-hospital, and staged out-of-hospital complete revascularization for patients with ST-segment-elevation myocardial infarction and multivessel disease. The primary outcome was major adverse cardiac events (MACEs).

Biomarkers of microbial translocation and generalized inflammation are associated with frailty among people with HIV.

Background: Frailty occurs at higher rates and younger ages among people with HIV (PWH) compared with the general population and is often attributed to chronic inflammation and subsequent immune exhaustion. We assessed how inflammatory biomarkers are associated with frailty among PWH.

Methods: The Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort is comprised of adult PWH in care at 10 sites, and harmonizes demographic, clinical, and patient-reported outcomes (PRO) data.

Treatment of Unruptured Small and Medium-Sized Wide Necked Aneurysms Using the 64-Wire Surpass Evolve: A Subanalysis From the SEASE International Registry.

Background: Flow diversion has revolutionized the management of wide-necked intracranial aneurysms (IAs). We aimed to assess the effectiveness and safety of the new generation 64-wire Surpass Evolve for the treatment of unruptured small/medium-sized IAs.

Methods And Results: This is a subanalysis from the SEASE (Safety and Effectiveness Assessment of the Surpass Evolve) registry, an observational cohort study including 15 academic institutions in North America and Europe between July 2020 and October 2022.

Rapid Resolution of Delayed Facial Palsy in Miller Fisher Syndrome With Steroid Therapy.

Miller Fisher syndrome (MFS), a variant of Guillain-Barre syndrome (GBS), is characterized by the classic triad of ataxia, areflexia, and ophthalmoplegia. Approximately 20% of MFS patients experience facial weakness, with a subset developing delayed facial palsy (DFP) after other neurological symptoms have peaked or begun to improve. Initially, DFP was considered a natural progression of MFS, leading to recommendations against additional treatment.

Prodrug nanotherapy demonstrates anticryptosporidial efficacy in a mouse model of chronic infection.

The gastrointestinal disease cryptosporidiosis, caused by the genus , is a common cause of diarrheal diseases in children, particularly in developing countries and frequently fatal in immunocompromised individuals. ()-specific bifunctional dihydrofolate reductase-thymidylate synthase (DHFR-TS) has been a molecular target for inhibitor design. (.

The effect of intravenous thrombolysis in stroke patients with unsuccessful thrombectomy.

Background: The benefit of intravenous thrombolysis (IVT) is well established. We aim to study the benefits of IVT in acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) who underwent unsuccessful mechanical thrombectomy (MT).

Methods: We included AIS patients who underwent MT for anterior circulation LVO with failed recanalization (modified treatment in cerebral ischemia [mTICI] score ≤ 2A).

Trem2/Syk/PI3K axis contributes to the host protection against Toxoplasma gondii-induced adverse pregnancy outcomes via modulating decidual macrophages.

Decidual macrophages residing at the maternal-fetal interface have been recognized as pivotal factors for maintaining normal pregnancy; however, they are also key target cells of Toxoplasma gondii (T. gondii) in the pathology of T. gondii-induced adverse pregnancy.

Association Between Metformin Use in Early Gestational or Type 2 Diabetes in Pregnancy and Preterm Preeclampsia.

Objective: To estimate the association between maternal metformin use for the treatment of early gestational or pre-existing type 2 diabetes and preterm preeclampsia.

Methods: This is a planned secondary analysis of the MOMPOD study (Medical Optimization of Management of Overt Type 2 Diabetes in Pregnancy), a randomized trial comparing the effect of adding metformin with insulin treatment on composite neonatal outcome in singleton pregnancies with early gestational or type 2 diabetes. Participants were randomized at 11-23 weeks of gestation to 1,000 mg metformin twice daily or placebo until delivery.

Exploring the gender gap in neurosurgery: A cross-sectional analysis of preresidency publications among neurosurgery residents.

Background And Aims: While the number of female physicians has increased since the 1970s, there continues to be a lack of female surgeons compared to their male counterparts, with the gender gap more prominent in surgical subspecialties such as neurosurgery. While surgical subspecialities have accelerated initiatives to close the gap, potential disparities in research opportunities may position women at a disadvantage, particularly in neurosurgery, where academic publications are an indicator of residency match success. In this paper, we sought to investigate whether gender disparities exist in preresidency neurosurgery publications among current neurosurgery residents.

Fatal journeys: causes of death in international travellers in South America.

Background: Understanding mortality among travellers is essential for mitigating risks and enhancing travel safety. However, limited evidence exists on severe illnesses and injuries leading to death among travellers, particularly in low- and middle-income countries and remote regions.

Methods: We conducted a retrospective census study using country-level observational data from death certificates of travellers of seven South American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Uruguay) from 2017 to 2021.